Evidence map›Paper›PMID 30421445›Full record

ArticleClinical cardiology2019

Sex-differences in post-discharge outcomes among patients hospitalized for atrial fibrillation.

Bindu Kalesan, Amartya Kundu, Aditya Vaze, Elizabeth Pino, Allan J Walkey, Ramachandran S Vasan, David D McManus

Abstract readComparative StudyMulticenter Study
In one paragraph

Article in Clinical cardiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Bindu KalesanCenter for Translational Epidemiology and Comparative Effectiveness Research and Department of Community Health Sciences, Boston University School of Medicine and Public Health, Boston, Massachusetts.
Amartya KunduDepartment of Cardiology, University of Massachusetts Medical School, Worcester, Massachusetts.ORCID https://orcid.org/0000-0003-0089-0528
Aditya VazeDepartment of Cardiology, University of California Irvine School of Medicine, Irvine, California.
Elizabeth PinoCenter for Translational Epidemiology and Comparative Effectiveness Research and Department of Community Health Sciences, Boston University School of Medicine and Public Health, Boston, Massachusetts.
Allan J WalkeyDivision of Preventive Medicine and Epidemiology and Cardiovascular Medicine, Department of Medicine, Boston University Medical School, Boston, Massachusetts.
Ramachandran S VasanDivision of Preventive Medicine and Epidemiology and Cardiovascular Medicine, Department of Medicine, Boston University Medical School, Boston, Massachusetts.
David D McManusDepartment of Cardiology, University of Massachusetts Medical School, Worcester, Massachusetts.

Funding

Systematic Assessment of Geriatric Elements in Atrial Fibrillation (SAGE-AF)R01HL126911 · NHLBI · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI MCMANUS, DAVID D., SACZYNSKI, JANE STEELE · 2016 to 2019
$3.2M
University of Massachusetts Center for Clinical and Translational ScienceKL2RR031981 · NCRR · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI SULLIVAN, JOHN LEWIS · 2010 to 2011
$1.2M
Edward P. Evans FoundationNCRR NIH HHS KL2 RR031981NHLBI NIH HHS R01 HL126911NIH Blueprint for Neuroscience Research 1R01HL126911-01A1NIH Blueprint for Neuroscience Research KL2RR031981
6 · The paper itself

Abstract

backgroundPatients with atrial fibrillation (AF) are at risk for both thromboembolic and bleeding complications. While the risk for thromboembolism is higher among women with AF than men, the sex-related differences in post-discharge outcomes after hospitalization is not clearly understood. HYPOTHESIS: Compared to men, women hospitalized for AF are at a higher risk of both thromboembolic and bleeding complications.

methodsWe conducted a retrospective cohort study using data from the 2013 to 2014 Nationwide Readmission Database (NRD), to compare outcomes among men and women, ≥50 years of age after hospitalization for AF. The primary patient outcome was all-cause rehospitalization at 90-days after initial hospitalization. Survey-weighted Cox proportional hazard regression models were used to estimate the hazard ratios (HR) and their 95% confidence intervals (CI) for bleeding events at 30, 60, 90, and 270 days after hospitalization.

resultsFrom the 28 million patients in the NRD, we identified 522 521 individuals with an index hospitalization for AF. Compared to men, women hospitalized for AF accounted for 53.3% of the cohort and had higher rates of thrombotic (1.7%, 1.4%) and bleeding complications (1.4%, 1.1%). After adjustment, the 90-day risk among women vs men was significantly greater; all-cause rehospitalization (24.2%, 17.0%; HR = 1.07, 95% CI = 1.05-1.09), rehospitalization related to ischemic stroke (0.6%, 0.3%; HR 1.31, 95% CI = 1.14-1.51), pulmonary embolism (0.4%, 0.2%; HR 1.21, 95% CI = 1.01-1.45), and any thrombotic event (1.3%, 0.7%; HR 1.20, 95% CI = 1.09-1.32).

conclusionsHospitalization for AF is common and frequently associated with both in-hospital complications and readmission, which were more commonly observed among women with AF. Further research into epidemiological factors and treatment differences between men and women with AF is warranted.

Indexed as

InpatientsAgedAged, 80 and overAtrial FibrillationFemaleFollow-Up StudiesHemorrhageHumansMaleMiddle AgedPatient DischargePatient ReadmissionRetrospective StudiesRisk AssessmentRisk FactorsSex Distributionatrial fibrillationoutcomesreadmission

Identifiers

PMID30421445
PMCPMC6436504

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.